Provider Demographics
NPI:1760410252
Name:BENENSON, RONALD S (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:S
Last Name:BENENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:STE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-3469
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:YORK HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-2450
Practice Address - Fax:717-851-3469
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021674E207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA34348OtherGEISINGER
PA30120296OtherAMERIHEALTH MERCY - CE
PA000877055Medicaid
PA110090012OtherRAILROAD MEDICARE
PA1141123OtherAMERIHEALTH MERCY-YH
PA145106OtherHIGHMARK BLUE SHIELD
PA0068519000OtherAMERIHEALTH 65 PA
PA1537577OtherGATEWAY-YH
PA30120297OtherAMERIHEALTH MERCY - WRC
PA50067204OtherCAPITAL BLUE CROSS-YH
PA145106OtherHIGHMARK BLUE SHIELD
PA1537577OtherGATEWAY-YH
PA110090012Medicare PIN